PHILLIP DONNELL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034541

License Status

EXPIRED

Business

First Name

PHILLIP

Last Name

DONNELL

Suffix

Business Name

PHILLIP DONNELL MD

Original Issue Date

05/20/1996

Effective Date

05/20/1996

Expiration Date

01/26/2002

City

N CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006